Increases in Advance Directive Completion Through the Patient Portal Among Younger and Healthier Population During the COVID-19 Pandemic

Abstract

Objectives:

To identify differences in the number and characteristics of patients who completed a Medical Durable Power of Attorney (MDPOA) form through the patient portal during the COVID-19 pandemic compared to pre-pandemic.

Methods:

Data, including portal-based MDPOA forms, were extracted from the electronic health record at one U.S. institution (July 2017–May 2023). The pandemic period was defined as March 26, 2020, or after.

Results:

397,682 patients added an MDPOA form during the study period. There was an increase in the proportion of portal-based MDPOA forms from 4.6% pre-pandemic to 5.1% during the pandemic (p < 0.001). Patients who used the portal to complete the MDPOA form during the pandemic were younger (p < 0.001) and had fewer comorbidities (p < 0.001) compared to pre-pandemic patients who completed a portal-based MDPOA form.

Conclusion:

MDPOA completion is important for patients of all ages and health statuses. Having MDPOA tools within a patient portal can support uptake among younger, healthier populations.

Keywords

advance care planning COVID-19 medical decision-making patient portal surrogate decision maker

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